Execution:
- The patient is in prone lying position with the ankles over the edge of the table
- The examiner palpates the Achilles tendon in a distal to proximal direction, between 2-6cm above the insertion into the calcaneus gently squeezing the tendon between the index finger and thumb feeling for localised thickening of the tendon
- The patient is asked to dorsiflex and plantarflex the ankle while the palpating fingers stay on the area of swelling
Positive Outcome: In tendinopathy of the main body of the tendon, the area of swelling moves with dorsiflexion and plantarflexion. If an area of swelling cannot be identified, an area in the tendon 3cm proximal to the calcaneal insertion is palpated during the movement.
If the palpable thickening does not move, but stay relatively still with palpable crepitations, the tendon sheath might be suspected as the area of injury. The use of a stethoscope might be a helpful addition in case crepitations cannot be felt
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Reiman et al. (2014) | NA | 42 | 88 | 3.24 | 0.68 |
| Comment: The included studies used ultrasound as the gold standard and one has to keep in mind that many asymptomatic tendons will show pathology on imaging | |||||
